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1.
Isr Med Assoc J ; 21(8): 546-551, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474018

RESUMO

BACKGROUND: The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin.


Assuntos
Anemia/etnologia , Hemoglobina A Glicada/análise , Hemoglobinopatias/etnologia , Desnutrição/etnologia , Complicações na Gravidez/etnologia , Anemia/sangue , Anemia/complicações , Árabes , Feminino , Hemoglobinopatias/sangue , Hemoglobinopatias/complicações , Humanos , Islamismo , Israel/etnologia , Masculino , Desnutrição/sangue , Desnutrição/complicações , Gravidez , Complicações na Gravidez/sangue , Reprodutibilidade dos Testes , Fatores Socioeconômicos
2.
Rev Assoc Med Bras (1992) ; 65(7): 952-958, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31389504

RESUMO

PURPOSE: In this prospective observational study, we aimed to investigate the role of the maximum compressed (MC) and uncompressed (UC) thickness of the quadriceps femoris muscle (QFMT) measured by ultrasonography (USG) in the detection of nutritional risk in intensive care patients (ICPs) with different volume status. METHODS: 55 patients were included. Right, left, and total ucQFMT and mcQFMT measurements were obtained by a standard USG device within the first 48 hours after ICU admission. Clinical examination and the USG device were used to determine the volume status of the patients. SOFA, APACHE II, modified NUTRIC scores, and demographic data were collected. RESULTS: There was a significant difference between the nutritional risk of patients in terms of left, right, and total mcQFMT measurements (p=0.025, p=0.039; p=0.028, respectively), mechanical ventilation requirement (p=0.014), presence of infection (p=0.019), and sepsis (p=0.006). There was no significant difference between different volume statuses in terms of mcQFMT measurements. In the multi-variance analysis, mcQFMT measurements were found to be independently associated with high nutritional risk (p=0.019, Exp(B)=0.256, 95%CI=0.082-0.800 for modified NUTRIC score ≥ 5), and higher nutritional risk (p=0.009, Exp(B)=0.144, 95%CI=0.033-0.620 for modified NUTRIC score ≥ 6). a Total mcQFMT value below 1.36 cm was a predictor for higher nutritional risk with 79% sensitivity and 70% specificity (AUC=0.749, p=0.002, likelihood ratio=2.04). CONCLUSION: Ultrasonographic measurement of total mcQFMT can be used as a novel nutritional risk assessment parameter in medical ICPs with different volume statuses. Thus, patients who could benefit from aggressive nutritional therapy can be easily identified in these patient groups.


Assuntos
Estado Nutricional/fisiologia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/patologia , Ultrassonografia/métodos , APACHE , Idoso , Idoso de 80 Anos ou mais , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Modelos Logísticos , Masculino , Desnutrição/diagnóstico por imagem , Desnutrição/patologia , Desnutrição/fisiopatologia , Pessoa de Meia-Idade , Avaliação Nutricional , Terapia Nutricional/métodos , Estudos Prospectivos , Músculo Quadríceps/fisiopatologia , Valores de Referência , Respiração Artificial/efeitos adversos , Medição de Risco , Sensibilidade e Especificidade
3.
Zhen Ci Yan Jiu ; 44(6): 451-3, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31368271

RESUMO

OBJECTIVE: To investigate the clinical effect of acupuncture at Sifeng (EX-UE10) combined with Wang's Baochi Pills in the treatment of pediatric malnutrition, so as to provide a more effective method for pediatric malnutrition. METHODS: A total of 201 children with malnutrition were randomly divided into combined treatment group (n=102) and control (Baochi Pill) group (n=99). The children in the combined treatment group were treated by acupuncture stimulation of Sifeng (EX-UE10, till no more yellowish-white effusion out) and oral administration of Wang's Baochi Pills, and those in the control group treated by oral administration of Wang's Baochi Pills only. The course of treatment was one month for both groups. The integral score of symptom was assessed according to the main symptoms as body weight and height and food-intake, and to the secondary symptoms including mentality, agitation, sleep, hair gloss, susceptibility to cold, hydrosis, abdominal distension, and susceptibility to diarrhea or constipation. The therapeutic effect was assessed by consulting the "Criteria for Diagnosis and Therapeutic Effect Evaluation of Syndromes/Illnesses of Traditional Chinese Medicine (TCM)" and "TCM Professional Criteria of the People's Republic of China for Diagnosis and Therapeutic Effect Evaluation of Syndromes/Diseases of TCM Pediatric". RESULTS: After the treatment, the total symptom scores of both groups were significantly decreased in comparison with their own pre-treatment (P<0.05), and the scores of total symptom after the treatment and the 1st, 2nd and 3rd follow-up surveys were obviously lower in the combined treatment group than in the control group (P<0.05). Of the 99 and 102 cases in the control and combined treatment groups, 47 and 59 were cured, 39 and 37 experienced improvement in their symptoms, and 13 and 6 failed, with the effective rate being 86.87% (86/99) and 94.11%(96/102), respectively. The effective rate of the combined treatment was evidently higher than that of the simple medication (P<0.05). CONCLUSION: Acupuncture of Sifeng (EX-UE10) combined with Wang's Baochi Pills is better than administration of Wang's Baochi Pills alone in the therapeutic effect for pediatric malnutrition.


Assuntos
Terapia por Acupuntura , Desnutrição , Administração Oral , Criança , China , Humanos , Desnutrição/terapia , Medicina Tradicional Chinesa
5.
Medicine (Baltimore) ; 98(27): e16290, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277161

RESUMO

Patients who become malnourished during hospitalization because of illness or treatment often receive intervention from a nutrition support team (NST). The NST intervention not only enhances the nutritional status but also decreases medical expenses and catheter-related complications. However, the impact of the NST intervention on the home discharge of hospitalized community-dwelling older adults remains unclear. Hence, this study aims to investigate factors related to home discharge in malnourished community-dwelling older adults.In this retrospective longitudinal cohort study, examined 191 community-dwelling older adults aged ≥65 years (108 males; mean age: 80.9 ±â€Š7.8 years) who received the NST intervention. All participants were categorized into two groups based on whether they were home discharged or not (home discharge group and non-home discharge group). We performed intergroup comparisons using serum albumin (Alb) as an index of the nutritional status and functional independence measure (FIM: motor and cognitive items) as an index of activities of daily living (ADL). Furthermore, we constructed a prognostic model of home discharge using the logistic regression analysis.The home discharge group had 94 participants, with a home discharge rate of 50.8%. Baseline body mass index (BMI), motor-FIM score, and cognitive-FIM score were significantly higher in the home discharge group compared with the non-home discharge group (P = .002, P < .001, P < .001, respectively). In the home discharge group, BMI declined significantly, Alb elevated significantly, and both motor-FIM and cognitive-FIM score enhanced significantly by the completion of the NST intervention (P < .001, P < .001, P < .001, P = .005, respectively). The adjusted logistic regression analysis extracted the baseline BMI (odds ratio [OR], 1.146; 95% confidence interval [CI]: 1.034-1.270), baseline motor-FIM score (OR, 1.070; 95% CI: 1.036-1.105), and extent of change in the motor-FIM score (OR, 1.061; 95% CI: 1.026-1.098) as independent factors that predict home discharge.This study highlights the significance of higher baseline BMI, higher baseline ADL level, ADL enhancements, and improvements in the nutritional status by the NST intervention in malnourished community-dwelling older adults considering home discharge.


Assuntos
Atividades Cotidianas , Desnutrição/terapia , Estado Nutricional , Apoio Nutricional/métodos , Alta do Paciente/tendências , Recuperação de Função Fisiológica/fisiologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Desnutrição/fisiopatologia , Prognóstico , Estudos Retrospectivos
6.
Bone Joint J ; 101-B(7_Supple_C): 17-21, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31256648

RESUMO

AIMS: To date, no study has demonstrated an improvement in postoperative outcomes following elective joint arthroplasty with a focus on nutritional intervention for patients with preoperative hypoalbuminaemia. In this prospective study, we evaluated differences in the hospital length of stay (LOS), rate of re-admission, and total patient charges for a malnourished patient study population who received a specific nutrition protocol before surgery. PATIENTS AND METHODS: An analytical report was extracted from the electronic medical record (EMR; Epic, Verona, Wisconsin) of a five-hospital network joint arthroplasty patient data set between 2014 and 2017. A total of 4733 patients underwent joint arthroplasty and had preoperative measurement of albumin levels: 2220 at four hospitals and 2513 at the study hospital. Albumin ≤ 3.4 g/l, designated as malnutrition, was found in 543 patients (11.5%). A nutritional intervention programme focusing on a high-protein, anti-inflammatory diet was initiated in January 2017 at one study hospital. Hospital LOS, re-admission rate, and 90-day charges were compared for differential change between patients in study and control hospitals for all elective hip and knee arthroplasty patients, and for malnourished patients over time as the nutrition intervention was implemented. RESULTS: Malnourished patients with nutritional intervention at the study hospital had shorter hospital LOS beginning in 2017 than malnourished patients at control hospitals during the same period (p = 0.04). Similarly, this cohort had significantly lower primary hospitalization charges, charges associated with hospital re-admissions, and 90-day total charges (p < 0.001). Inclusion of covariant potential confounders (age, anaemia, diabetes, and obesity) did not alter the conclusions of the primary statistical analysis. CONCLUSION: Joint arthroplasty outcomes were positively affected in study patients with low albumin when a high-protein, anti-inflammatory diet was encouraged. Elective surgery was neither cancelled nor delayed with a malnutrition designation. While the entire network population experienced improved postoperative outcomes, malnourished control patients did not experience this improvement. This study demonstrated that education on malnutrition can benefit patients. Cite this article: Bone Joint J 2019;101-B(7 Supple C):17-21.


Assuntos
Artroplastia de Quadril/métodos , Artroplastia do Joelho/métodos , Procedimentos Cirúrgicos Eletivos/métodos , Desnutrição/complicações , Estado Nutricional , Apoio Nutricional/métodos , Osteoartrite/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Tempo de Internação/tendências , Masculino , Desnutrição/terapia , Pessoa de Meia-Idade , Osteoartrite/complicações , Alta do Paciente/tendências , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
7.
Rev. Hosp. El Cruce ; (24): 8-11, 18/07/2019.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1006636

RESUMO

OBJETIVO: Conocer el estado nutricional y la terapia nutricional recibida durante la internación de los pacientes sometidos a TCPH. MATERIAL Y MÉTODOS: Estudio observacional, de corte transversal, comprendido en el período de enero de 2012 a octubre de 2017. Se incluyeron 100 pacientes mayores de 15 años internados en la unidad de trasplante de médula ósea, que se encontraban realizando tratamiento acondicionante y posterior TCPH, que respondieron voluntariamente al interrogatorio realizado por el Servicio de Nutrición. En una base de datos se registró el estado nutricional y el tipo de terapia nutricional, con los motivos de indicación, la duración y las causas de finalización de la misma. RESULTADOS: De la totalidad de los pacientes, el 84% se mantuvo con alimentación oral exclusiva, adecuándose la dieta a la sintomatología referida por el paciente; y de éstos, el 62% (52 pacientes) tuvieron indicación de suplementos orales como complemento. Sólo 16 pacientes tuvieron indicación de NP. La mediana de duración de NP fue de 9 días (IIC 6-24,5) CONCLUSIONES: La mayoría de los pacientes no presentó desnutrición a su ingreso, pero a pesar de ello, hubo un gran número de pacientes que requirió el uso de alguna terapia nutricional, lo que denota la importancia del monitoreo diario de estos pacientes a pesar de no presentar riesgo nutricional al ingreso.


OBJECTIVE: To know the nutritional status and nutritional therapy received during hospitalization of patients undergoing TCPH. MATERIAL AND METHODS: Observational, cross-sectional study, included in the period from January 2012 to October 2017. We included 100 patients older than 15 years admitted to the bone marrow transplant unit, who were undergoing conditioning treatment and subsequent TCPH, who voluntarily responded to the interrogation conducted by the Nutrition Service. In a database, the nutritional status and type of nutritional therapy were recorded, with the reasons for indication, the duration and the causes of the end of it. RESULTS: Of the totality of the patients, 84% remained with exclusive oral feeding, adapting the diet to the symptomatology referred by the patient; and of these, 62% (52 patients) had an indication for oral supplements as a complement. Only 16 patients had an NP indication. The median duration of NP was 9 days (IIC 6-24.5) CONCLUSIONS: The majority of patients did not present malnutrition at admission, but despite this, there was a large number of patients that required the use of some nutritional therapy, which indicates the importance of daily monitoring of these patients despite not present nutritional risk to income.


Assuntos
Avaliação Nutricional , Transplante de Células-Tronco Hematopoéticas , Terapia Nutricional , Desnutrição
8.
Rev Med Liege ; 74(5-6): 304-309, 2019 05.
Artigo em Francês | MEDLINE | ID: mdl-31206271

RESUMO

Metabolic disturbances associated with chronic alcohol consumption, among which those affecting glucose regulation, lipid profile, uric acid and nutritional status, are described. In fact, alcohol abuse can lead to overweight and obesity, but also to protein-caloric malnutrition. Finally, we will discuss concerns about vitamin and mineral deficiencies that may be observed in alcoholic people and can contribute to aggravate somatic complications.


Assuntos
Consumo de Bebidas Alcoólicas , Desnutrição , Obesidade , Consumo de Bebidas Alcoólicas/efeitos adversos , Humanos , Estado Nutricional , Ácido Úrico
9.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(3): 510-518, 2019 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-31209424

RESUMO

OBJECTIVE: To investigate the relationship between malnutrition-inflammation-atherosclerosis (MIA) syndrome and deterioration of global and specific domains of cognitive function in peritoneal dialysis (PD) patients. METHODS: This was a multi-center prospective cohort study. The PD patients who met the inclusion criteria were examined with general and specific cognitive function between March 2013 and November 2013. The patients were divided into MIA0, MIA1 and MIA2 groups, according to items of "Yes" for whether or not having cardiovascular disease, serum albumin≤35 g/L or high-sensitive C-reactive protein (hs-CRP) ≥3 mg/L. After 2 years, the patients maintained on PD would be repeatedly measured with cognitive function. The Chi-square test, One-way ANOVA, Kruskal-wallis H rank sum test were used to compare the differences of clinical characteristics, biochemical data, and global and specific cognitive function parameters among the three groups at baseline, and two years later, respectively. The Bonferroni method was applied to adjust the significance level for further comparison between each two different groups. The change of score in each cognitive parameter of global and specific domains was used as dependent variable. Age, gender, education level, depression index, body-mass index, diabetes mellitus, serum sodium levels and MIA (MIA0 was control, MIA1 and MIA2 as dummy variables) were all included in the multivariable linear regression models to analyze the risk factors of the deterioration of cognitive function. The analysis for each cognitive domain was adjusted for the baseline score of the corresponding cognitive parameter. All the analyses were performed using SPSS for Windows, software version 25.0 (SPSS Inc., Chicago, IL). RESULTS: Over two-year follow up, the prevalence of cognitive impairment increased from 20.0% to 24.7%, absolute decrease of 3MS scores were more significantly decreased in MIA2 (-3.9±12.0 vs. 1.1±6.7, P<0.01) and MIA1 group (-2.3±11.8 vs. 1.1±6.7, P<0.05) than those in MIA0 group respectively. Specific cognitive functions, included executive function (trail-making tests A and B, P=0.401, P=0.176), immediate memory (P=0.437), delayed memory (P=0.104), visuospatial skill (P=0.496), and language ability (P=0.171) remained unchanged. Advanced age, lower education, diabetes mellitus and depression were all correlated with the deterioration of one or more cognitive domains, and the patients having one item of MIA syndrome were prone to develop the deterioration of 3MS (P=0.022). Furthermore, the patients having two or more items of MIA syndrome were more likely to develop the deterioration of not only 3MS (P <0.001), but also delayed memory, visuospatial skill, and language ability (P=0.002, P=0.007, P=0.004, respectively). CONCLUSION: Patients with one item or above of MIA syndrome were at high-risk for the deterioration of global cognitive function. The more MIA syndrome items there were, the more specific cognitive domains deteriorated.


Assuntos
Doenças Cardiovasculares , Disfunção Cognitiva/complicações , Desnutrição , Diálise Peritoneal , Proteína C-Reativa , Doenças Cardiovasculares/etiologia , Cognição , Estudos Transversais , Humanos , Inflamação/etiologia , Desnutrição/etiologia , Estudos Prospectivos
10.
Gan To Kagaku Ryoho ; 46(Suppl 1): 107-109, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189829

RESUMO

At the start of home-visit nutritional guidance by managerial dietician, we investigated nutritional status of patients receiving home care. Subjects included 76 patients receiving home care who started care between May 2018 and July 2018. Among the patients, 85.5%were aged 75 years or older. Serum albumin(Alb)values were used for nutritional assessment. Medium to high risk of malnutrition were found in 35 patients(46%). We want to engage in multi-professional support for those cared persons by giving home-visit nutritional guidance.


Assuntos
Serviços de Assistência Domiciliar , Desnutrição , Idoso , Avaliação Geriátrica , Visita Domiciliar , Humanos , Avaliação Nutricional , Estado Nutricional
11.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 330-342, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177656

RESUMO

Malnutrition is common in patients with end-stage liver disease (ESLD) and is an independent risk factor for survival, therefore it should be treated as the same important guideline as ascites and hepatic encephalopathy. However, up to now, there is no clinical nutrition guideline for patients with ESLD in China. In order to standardize the nutrition treatment, Chinese Society of Hepatology (CSH) and Chinese Society of Gastroenterology (CSGE), Chinese Medical Association(CMA) co-organized and co-developed this guideline. Recommendations on nutritional screening and assessment as well as principles of intervention and management in patients with ESLD were provided to help clinicians make rational decisions on clinical malnutrition.


Assuntos
Doença Hepática Terminal/complicações , Gastroenterologia/normas , Encefalopatia Hepática , Cirrose Hepática/complicações , Desnutrição/dietoterapia , Guias de Prática Clínica como Assunto , Ascite , China , Doença Hepática Terminal/fisiopatologia , Nutrição Enteral/normas , Humanos , Desnutrição/fisiopatologia , Avaliação Nutricional , Estado Nutricional
12.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(5): 341-346, jun. 2019. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-180921

RESUMO

La lengua geográfica, también conocida como glositis migratoria benigna, es una condición inflamatoria crónica benigna de la lengua. Se caracteriza por presentar lesiones eritematosas asociadas a una atrofia de papilas, las que están rodeadas por áreas blanquecinas bien delimitadas y localizadas predominantemente en la cara lateral y dorsal de la lengua, lo que da una imagen que recuerda un mapa geográfico. Estas lesiones pueden variar tanto de tamaño como de forma durante su evolución; además, presentan periodos de exacerbación y remisión sin dejar lesiones cicatriciales residuales. La causa de esta entidad sigue siendo desconocida, sin embargo, múltiples asociaciones se han descrito, las que son comentadas a continuación


Geographic tongue, also known as benign migratory glossitis, is a benign chronic inflammatory condition of the tongue. It is characterized by erythematous lesions with filiform papillae atrophy, surrounded by white limited areas in the dorsal and lateral aspects of the tongue, producing a map-like aspect. This lesions change in size and shape with time, and are characterized by periods of exacerbation and remission without scaring. The cause is unknown, but multiple associations have been described, which will be discussed below


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Glossite Migratória Benigna/etiologia , Língua/fisiopatologia , Glossite Migratória Benigna/diagnóstico , Glossite Migratória Benigna/tratamento farmacológico , Psoríase/fisiopatologia , Hipersensibilidade , Dermatite Atópica , Deficiência de Vitamina D , Doença Celíaca , Desnutrição , Infecção , Sintomas Concomitantes
13.
Saudi Med J ; 40(6): 568-574, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31219491

RESUMO

OBJECTIVES:  To determine the prevalence of sarcopenia and related factors in individuals aged ≥65 years living in the Bornova district of Izmir, Turkey. Sarcopenia is one of the most serious health problems among elderly individuals. METHODS:  This cross-sectional study was conducted in the Bornova district of Izmir, Turkey, between February-July 2015. This study participants were comprised of 909 individuals aged ≥65 years. The dependent variable was the presence of sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) approach was used for determining sarcopenia. The independent variables were socio-demographic and economic characteristics, healthy life behaviors and health status/condition. Data were collected at home through face-to-face interviews and measurements, analysed using chi-square test, t-test and logistic regression analysis. RESULTS:  The participants' mean age was 72.8±6.2 (range: 65-100) years, and 60.2% were female (n=582). The prevalence of sarcopenia was 5.2% and that of low gait speed was 41.0%, low grip strength was 57.0%, low calf circumference was 6.1% and the combination of low gait speed and low grip strength was 14.3%. Risk factors of sarcopenia included increasing age, physical inactivity, low body mass index and the presence or risk of malnutritionConclusion: The prevalence of sarcopenia was 5.2% in this population and increased with age, physical inactivity, low body mass index and the presence or risk of malnutrition.


Assuntos
Sarcopenia/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Estilo de Vida Saudável , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Desnutrição , Prevalência , Fatores de Risco , Sarcopenia/etiologia , Fatores Socioeconômicos , Turquia/epidemiologia
14.
Aging Clin Exp Res ; 31(6): 793-798, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31148100

RESUMO

Risk for or established malnutrition is frequent in older adults, accompanied by functional limitations, increased morbidity and mortality. Protein-energy malnutrition is often observed and leads besides other predisposing factors to sarcopenia, the increased loss of muscle mass with aging. Sarcopenia is an integral correlate of the physical component of the frailty syndrome. Even though sarcopenia often reaches levels where mobility, balance and functionality on overall are hampered, its diagnosis has not become part of the standard diagnostic and therapeutic repertoire of geriatric medicine. This will hopefully change with a recently published revised international definition of sarcopenia, as well an own ICD-number. From a pathophysiological point of view, both malnutrition and sarcopenia share many components, a low-inflammatory state (inflamm-aging) being an important one. Nutritional interventions with and without parallel physical activity programs can prevent and often also reverse sarcopenia. It is hoped that upcoming even more potent nutritional treatment options-including for sarcopenic obesity-will lower the burden of malnutrition and sarcopenia for many older adults.


Assuntos
Fragilidade/etiologia , Desnutrição/complicações , Sarcopenia/etiologia , Idoso , Envelhecimento/metabolismo , Exercício/fisiologia , Idoso Fragilizado , Fragilidade/fisiopatologia , Fragilidade/prevenção & controle , Humanos , Sarcopenia/fisiopatologia , Sarcopenia/prevenção & controle
15.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(6): 528-533, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31208504

RESUMO

OBJECTIVE: To investigate the nutritional status of critically ill hospitalized children and to explore the value of nutritional risk screening tools in the nutritional risk assessment. METHODS: The clinical data of 211 critically ill children who were admitted to the pediatric intensive care unit from November 2017 to April 2018 were collected to evaluate their nutritional status on admission and at discharge. Two nutritional risk screening tools, STRONGkids and PYMS, were used for nutritional risk screening in the 211 children. RESULTS: Among the 211 patients, 68 (32.2%) were found to have malnutrition on admission, with 34 cases each of moderate and severe malnutrition. Moderate or high nutritional risk was found in 154 cases (73.0%) with STRONGkids and 165 cases (78.2%) with PYMS. Using weight-for-age Z-score as the gold standard to evaluate the efficacy of the two nutritional risk screening tools, the areas under the receiver operating characteristic curves of STRONGkids and PYMS were 0.822 and 0.759 respectively. Both tools had a significant clinical value in screening for malnutrition (P<0.05), but there was no significant difference in clinical efficacy between them (P>0.05). With the optimal cut-off value of 3 points, the sensitivities of STRONGkids and PYMS for screening of malnutrition were 92.1% and 76.2% respectively. The children with moderate or high nutritional risk on admission had a significantly poorer prognosis than those with low nutritional risk (P=0.014 and 0.001 respectively). The children with severe malnutrition had a significantly poorer prognosis than those with normal nutrition (P=0.0009). CONCLUSIONS: The detection rates of malnutrition and nutritional risk are high in critically ill children. Malnutrition/high nutritional risk is related to a poor prognosis. Both STRONGkids and PYMS have a clinical value for nutritional risk screening in critically ill children, and they have similar clinical efficacy; however, STRONGkids is more sensitive.


Assuntos
Desnutrição , Avaliação Nutricional , Criança , Estado Terminal , Humanos , Programas de Rastreamento , Estado Nutricional , Medição de Risco
17.
Gac. méd. boliv ; 42(1): 39-46, jun. 2019. ilus., tab.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1007076

RESUMO

OBJETIVO: evaluar la estrategia multidimensional CLAPSEN a nivel biológico, cognitivo, social y del entorno ambiental en niños con desnutrición crónica. MÉTODOS: estudio descriptivo y de seguimiento longitudinal en 53 niños con retardo en crecimiento leve, moderado y severo. Ingresaron al modelo multidimensional de intervención comunitaria: Clínica, Laboratorio, Antropometría, Psicología, Educación y Nutrición (CLAPSEN). Se determinó el peso, talla, perímetro cefálico, perímetro braquial, pliegue cutáneo tricipital de la población en estudio, y ecografía del timo al inicio y final de la intervención. Luego de desparasitación de la población seleccionada, se realizó el seguimiento por ocho meses con la estrategia CLAPSEN. RESULTADOS: los niños recuperaron las condiciones biológicas y nutricionales siguientes, teniendo como resultados: el crecimiento de -2,11±0,7 a 0,6±0,3 (p≤0,001), anemia de 10,4 ±3,3 g/L a 12,5± 1,21 g/L(p≤0,001) las proteínas nutricionales mejoraron, las proteínas inflamatorias descendieron, la respuesta inmunitaria mejoró, reflejándose en la superficie del timo de 391,3±91 mm2 a 909,4±140,9 mm2(p≤0,001). CONCLUSIONES: la estrategia CLAPSEN, desde una visión multidimensional, fue útil para recuperar el retardo en crecimiento y desarrollo, para el control de posibles enfermedades crónicas y mejorar del entorno en el que vive el niño en forma relevante por el tiempo que duró el estudio.


OBJECTIVE: to evaluate the multidimensional strategy CLAPSEN at a biological, cognitive, social and environmental level in children with chronic malnutrition. METHODS: descriptive study and longitudinal follow-up over 53 children had mild, moderate and severe growth retardation entered into the new multidimensional model of community intervention: Clinical, Laboratory, anthropometric, psychology, Educational and nutrition (CLAPSEN). The weight, height, head circumference, brachial perimeter, triceps skinfold of the study population, in addition to extracting a blood sample for lab and ultrasound exams of the thymus at the beginning and end of the intervention was determined. After deworming of the selected population, the monitoring was carried out for eight months with the CLAPSEN. RESULTS: the children recovered the following biological and nutritional conditions, with the following results: growth from -2.11 ± 0.7 to 0.6 ± 0.3 (p≤0.001)), anemia of 10.4 ± 3 , 3 g / L to 12.5 ± 1.21 g / L (p≤0.001) the nutritional proteins improved, the inflammatory proteins decreased, the immune response improved, reflecting on the thymus surface of 391.3 ± 91 mm2 at 909.4 ± 140.9 mm2 (p≤0.001). CONCLUSIONS: the CLAPSEN strategy from a unified multidimensional vision was useful to recover the delay in growth and development, for the control of possible chronic diseases and to improve the environment in which the child lives in a relevant way for the time that the study lasted.


Assuntos
Desnutrição
18.
Gac. méd. boliv ; 42(1): 17-28, jun. 2019. ilus., tab.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1007158

RESUMO

La presencia concomitante de talla baja y obesidad, conocida como la doble carga de la malnutrición infantil, es observada con mayor frecuencia en países de bajos y medios ingresos económicos como el nuestro. OBJETIVO: analizar la prevalencia de la desnutrición y obesidad infantil en Cochabamba, Bolivia. MÉTODOS: se realizó un estudio observacional de corte transversal, con una muestra de n=4885 niños menores de 5 años, estratificada para las 5 macrorregiones de Cochabamba, aplicando el Sistema de Vigilancia Nutricional Comunitario. Las mediciones antropométricas se ingresaron al Software WHO-Anthro v3.1.0, para el cálculo de Z-score y su categorización. Se presentan proporciones e IC-95%; Chi2 para la asociación entre variables categóricas, correlación de Pearson para la interacción entre variables cuantitativas y regresión logística multivariada para el cálculo de Odds Ratio (OR) ajustados. RESULTADOS: encontramos una prevalencia de 22,1% para DNT-Crónica; 6,0% para DNT-Global; 6,1% para DNT-Aguda; 16,4% de probable retraso de crecimiento del perímetro cefálico y 10,8% con reserva energética inadecuada. La prevalencia de sobrepeso y obesidad fue del 16,5% para el indicador peso/talla; 17,6% según el IMC/edad y 10,8% para el PMB/Edad. El 66,03% de los niños con talla baja presentaban sobrepeso u obesidad. La prevalencia de desnutrición y obesidad fue mayor en la región andina, el grupo etario más afectado por la obesidad fueron los niños de 1 a 3 años. CONCLUSIÓN: existe una asociación estadísticamente significativa entre la talla baja y la presencia de obesidad; esta doble carga de malnutrición infantil fue más prevalente en la región andina.


A concomitant presence of chronically malnourished (stunted) and obesity, is known as the double burden of childhood malnutrition, is observed more frequently in low and middle-income countries. OBJECTIVE: to analyze the prevalence of underweight and childhood obesity in Cochabamba, Bolivia. METHODS: a cross-sectional study was conducted, with a sample of n=4885 children under 5 years, stratified for the 5 macro regions from Cochabamba, applying the Community Nutritional Surveillance System. The anthropometric measurements were entered into the WHO-Anthro Software v3.1.0, to calculate the Z-score and its nutritional status categorization. Proportions and IC-95% are presented; Chi2 to associations between categorical variables, Pearson correlation for the interaction between quantitative variables, and multivariate logistic regression for adjusted Odds Ratio (OR). RESULTS: we found a prevalence of 22,1% for estunted; 6,0% for global underweight; 6,1% for acute underweight; 16,4% probable delay of growth of the cephalic perimeter and 10,8% with inadequate energy reserve. The prevalence of overweight and obesity was 16,5% for the weight/height indicator; 17,6% according to the BMI/age and 10.8% for the MUAC/age. 66,03% of stunted children were overweight or obese. The prevalence of underweight and obesity was higher in the Andean region, the age group most affected by obesity were children from 1 to 3 years. CONCLUSION: there is a statistically significant association between stunted and obesity; this double burden of child malnutrition was more prevalent in the Andean region.


Assuntos
Humanos , Obesidade , Desnutrição
19.
Malar J ; 18(1): 173, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096985

RESUMO

BACKGROUND: In Latin America, where Plasmodium vivax malaria is more prevalent, it is known that this species plays an important role in the sustainability of transmission, and can have an impact on morbidity in terms of anaemia, nutritional status, and cognitive development in children. METHODS: The present study aimed to assess the impact of malaria infection on cognition of children in a peri-urban community in the Brazilian Amazon with moderate endemicity by applying Home Inventory and WPPSI-IV. A non-concurrent cohort study was designed and the cognitive, haematological, and nutritional profiles of the children were assessed. Children with documented malaria history were identified from official reported data. RESULTS: A total of 219 children aged between 2 and 7 years were enrolled. Although 205 (95%) children had normal birth weight, 177 (81%) were malnourished, and 35 (16%) had anaemia. Among the 100 (46%) children who experienced at least one episode of malaria, 89 (89%) children demonstrated low level of cognitive development. The findings showed that Plasmodium vivax malaria was an independent risk factor for low cognitive development. CONCLUSIONS: In addition to the known economic impact of malaria in the Amazon region, the study highlights the deleterious effects P. vivax malaria has on the socio-cultural development of the population.


Assuntos
Cognição , Malária Vivax/complicações , Malária Vivax/epidemiologia , Anemia/complicações , Anemia/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Desnutrição/complicações , Desnutrição/epidemiologia , Morbidade , Plasmodium vivax/isolamento & purificação , Prevalência , Fatores de Risco , Inquéritos e Questionários , População Urbana
20.
Microb Pathog ; 132: 254-260, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31075429

RESUMO

Early nutritional aggressions promote epigenetic adjustments that culminate in the loss of phenotype plasticity (with permanent long-term modifications). Maternal diet and inadequate neonatal nutrition can result in fetal programming that presents susceptibility to infections in adult life. Thus, it becomes essential to verify the impacts of neonatal malnutrition (even following nutritional replacement) on the immunological response to methicillin resistant Staphylococcus aureus (MRSA) infections. Male rats were divided into two distinct groups: Nourished and Malnourished. After isolation of mononuclear cells, four systems were established: negative control, positive control and two testing systems, (MSSA and MRSA). Tests were performed to analyze expression of TLR-9, NF-kB, IL-1ß, IL-18 and IL-33. For statistical analysis, we used the Student t and ANOVA tests p < 0.05. Even after nutritional replacement, malnutrition in the neonatal period compromised the animals' weight gains p < 0.05. There was a reduction in the expression of the immunological response in the positive control, however deregulation was observed in the gene expression of MRSA-infected macrophages, with a reduction in TLR-9 expression, and overexpression in NF-kB and cytokines p < 0.05. Puppies inflicted with protein-calorie malnutrition were compromised; (long-term) body growth and immune response. In the infectious scenario, immune collapse is reflected in inflammatory response exacerbation with a likely histolytic character. Immune disabling (resulting from gene expression deregulation) causes susceptibility to infections due to ineffective recognition, intense pro-inflammatory mediation, and cell death. It is suggested that neonatal malnutrition can program susceptibility to multiresistant bacterial infections, and generally favors a triggering of more intense confrontations with fatal outcomes.


Assuntos
Citocinas/metabolismo , Macrófagos/metabolismo , Macrófagos/microbiologia , Desnutrição/metabolismo , Staphylococcus aureus Resistente à Meticilina/patogenicidade , NF-kappa B/metabolismo , Infecções Estafilocócicas/imunologia , Receptor Toll-Like 9/metabolismo , Animais , Animais Recém-Nascidos , Peso Corporal , Cães , Regulação da Expressão Gênica , Interleucina-18/metabolismo , Interleucina-1beta/metabolismo , Interleucina-33/metabolismo , Macrófagos Alveolares/microbiologia , Masculino , Ratos , Ratos Wistar , Infecções Estafilocócicas/microbiologia
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